title: An alternative to open incision and drainage for community-acquired soft tissue abscesses in children.
abstract: BACKGROUND
  The continually rising incidence of soft tissue abscesses in children has prompted us to seek an alternative to the traditional open incision and drainage (I&D) that would minimize the pain associated with packing during dressing changes and eliminate the need for home nursing care.
  
  
  METHODS
  A retrospective review of all patients with soft tissue abscesses from November 2007 to June 2008 was conducted after institutional review board approval. Patients who were treated with open I&D were compared to those treated with placement of subcutaneous drains through the abscess cavities. Both groups received equivalent antibiotic treatment, and all patients were followed in outpatient clinics until infection resolved. The demographics, presenting temperature, culture results, and outcomes were compared between these 2 groups.
  
  
  RESULTS
  A total of 219 patients were identified; 134 of them underwent open I&D, whereas 85 were treated with subcutaneous drains. The demographics, anatomical location of the abscesses, and bacteriology were comparable between the 2 groups. There were equal number of patients in each group who presented with fever initially. Of those treated with open I&D, 4 had metachronous recurring abscesses within the same anatomical region and 1 patient required an additional procedure because of incomplete drainage. There were no recurrences or incomplete drainages in the subcutaneous drain group. The cosmetic appearance of the healed wound from subcutaneous drain placement during the immediate follow-up period is better than that of an open I&D.
  
  
  CONCLUSIONS
  Placement of a subcutaneous drain for community-acquired soft tissue abscesses in children is a safe and equally effective alternative to the traditional I&D.
authors.affiliation: Department of Surgery, State University of New York at Buffalo, Buffalo, NY 14222, USA.
authors.forename: William F
authors.initials: WF
authors.lastname: McNamara
authors.forename: Charles W
authors.initials: CW
authors.lastname: Hartin
authors.forename: Mauricio A
authors.initials: MA
authors.lastname: Escobar
authors.forename: Sani Z
authors.initials: SZ
authors.lastname: Yamout
authors.forename: Stanley T
authors.initials: ST
authors.lastname: Lau
authors.forename: Yi-Horng
authors.initials: YH
authors.lastname: Lee
mesh_terms: D000038:Abscess / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000188:drug therapy / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D002981:Clindamycin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D004954:Esthetics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D012008:Recurrence; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery; D040521:Subcutaneous Tissue / Q000601:surgery; D013396:Suction / Q000379:methods*; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination